ANATOMY & HISTOLOGY PLE 2019

Answers: Rationale and Reference

1. A 25-year-old male is admitted to the hospital with testicular pain. Hydrocele is an accumulation of serous fluid greater in amount than the amount normally
Physical examination reveals a swollen and inflamed right testis. CT scan present between the parietal and visceral testis tunica vaginalis layers. Abnormalities of these
examination reveals abnormal accumulation of fluid in the cavity of the tunica coverings and of the processus vaginalis communication with the peritoneal cavity may lead
vaginalis. Which of the following conditions will MOST accurately describe to several kinds of hydrocele.
the signs observed in the patient?
Netter Collection of Medical Illustrations: Reproductive System. P. 58
A. Varicocele 2nd edition. Volume I
B. Hydrocele
C. Cystocele
D. Rectocele
2. A 42-year-old mother of three children visits the outpatient clinic The ligament of the femoral head conveys a small blood vessel to supply the head of the
complaining that her youngest son cannot walk yet. Radiographic and femur primarily in childhood. The ligament is stretched during abduction and lateral rotation
physical examinations reveal an unstable hip joint. Which of the following ligaments of the hip join and has an important role in stabilizing an infant’s hip join before walking.
is responsible for stabilization of the hip joint in childhood?
A. Ischiofemoral Netter’s Introduction to Clinical Procedures
B. Ligament of the head of the femur P. 261
C. Pubofemoral
D. Iliofemora
3. A 56-year-old patient has an artificial cardiac pacemaker. Which of the The sinoatrial (SA) node initiates the impulse of contraction and is known as the pacemaker of
following conductive tissues of the heart had a defective function that required the the heart. Impulses from the SA node travel through the atrial myo- cardium to the AV node
pacemaker? and then race through the AV bundle (bundle of His), which divides into the right and left
A. Atrioventricular (AV) bundle bundle branches. The bundle breaks up into terminal conducting fibers (Purkinje fibers) to
B. Purkinje fiber spread out into the ventricular walls. The moderate band carries the right limb of the AV
C. AV node bundle from the septum to the sternocostal wall of the ventricle.
D. Sinoatrial ( S A ) node
BRS Anatomy 8th edition p94
4. A patient with a deep stab wound in the middle of the forearm has The anterior interosseous nerve is a branch of the median nerve and supplies the flexor
impaired movement of the thumb. Examination indicates a lesion of the anterior pollicis longus, half of the flexor digitorum profundus, and the pronator quadratus.
interosseous nerve. Which of the following muscles is paralyzed?
A. Flexor pollicis brevis and pronator quadratus BRS Gross Anatomy 8th edition P. 332
B. Flexor digitorum profundus and pronator quadratus
C. Flexor pollicis longus and opponens pollicis
D. Flexor digitorum profundus and superficialis
5. A teenage girl presents with paroxysms of dyspnea, cough, The teenage patient is suffering from an asthmatic attack, probably allergen induced.
and wheezing. Her parents indicate that she has had these "attacks" during cold Mast cells are a key player in this airway disease. Mast cells in the bronchioles are stimulated
months, and worsens during the allergy season. Which of the following cell types is to release histamine and heparin that induce the contraction of smooth bronchiolar muscle
correctly matched to a function it may perform in this patient's disease? and edema in the wall.
A. Cilia in alveoli, enhanced mucociliary transport
B. Eosinophils, bronchodilation Pretest Anatomy, Histology & Cell Biology 3rd edition P 297
C. Mast cells , edema
D. Goblet cells in bronchioles, hyposecretion
 6. A 30-year old female patient complains that she has been weak and easily The appendix is a narrow, hollow tube that is suspended from the cecum by a small
fatigued over the past 6 months. She has a 3-month acute history of severe mesoappendix.
hypertension that has required treatment with antihypertensive
medications. She has recently gained 4.5 kg (10 lb) and currently weighs 75 Gray's Anatomy Review. P 88
kg (165 lbs). Her blood pressure is 170/100 mmHg. Purple striae are seen
over the abdomen on physical examination and she possesses a “buffalo
hump.” Fasting serum glucose concentration is 140 mg/dl. A CT scan over
the abdomen shows a 6-cm mass immediately posterior to the inferior
vena cava. Which of the following organs is the origin of the mass.

A. Appendix
D. Gallbladder
C. Suprarenal (adrenal) gland
D. Ovary
7. A first-year resident in the urology department reviews pelvic anatomy The seminal vesicles store NO spermatozoa. The duct of the bulbourethral gland opens into
before seeing patients. Which of the following statements is correct? the bulbous portion of the spongy urethra
The greater vestibular gland opens into the vestibule between the labium minora and the
A. The duct of the bulbourethral gland open into the membranous urethra. hymen.
B. The duct of the greater vestibular gland open into the vagina.
C. The seminal vesicles store spermatozoa. BRS Gross Anatomy 8th edition P. 206
D. The dorsal artery of the penis supplies tho glottis penis.
8. A thoracentesis is performed to aspirate an abnormal accumulation of A thoracentesis is performed for aspiration of fluid in the pleural cavity at or posterior to the
fluid in a 40-year-cld patient with pleural effusion. A noodle should be midaxillary line one or two intercostal spaces below the fluid level but not below the ninth
inserted at the midaxillary line between which of the following two ribs intercostal space and, therefore, between ribs 7 and 9. Other intercostal spaces are not
so as to avoid puncturing the lung? preferred.

A. Ribs 3 and 5 BRS Gross Anatomy 8th edition P.95

B. Ribs 1 and 3
C. Ribs 7 and 9
D. Ribs 5 and 7
9. A 47-year-old patient complains of chest pain and headache. CT scan The azygos vein arches over the root of the right lung and empties into the SVC. Other veins
reveals a tumor located just superior to the root of the right lung. do not pass over the root of the right lung.
Blood flow in which of the following veins in MOST likely blocked by
this tumor? BRS Anatomy 8th Edition. P 101

A. Right brachiocephalic vein

B. Right subclavian vein
C. Accessory hemiazygos vein
D. Arch of the azygos vein
10. Tropocollagen is not assembled in the cell because of which one of the Non helical registration peptides at the ends of the triple helix prevent tropocollagen
following? assembly in the RER, Golgi Apparatus, and secretory vesicles.
A. Action of lysyl oxidase in tho Golgi apparatus
B. Cross-linking of tropocollagen in the roughendoplasmic reticulum (RER) Pretest Anatomy, Histology & Cell Biology 3rd edition P 173.
C. Presence of nonhelical registration peptides at the ends of the triple helix
D. Presence of specific collagenases in the RER and Golgi apparatus
 11. A 52-year-old female with a history of brain tumor and associated The right primary bronchus is shorter, wider, and more vertical than the left main bronchus.
Severe oropharyngeal dysphagia develops right lower lobe pneumonia When a foreign body is aspirated, it is more likely to enter the right main bronchus.
after an episode of vomiting. Which of the following is the BEST reason Pulmonary vascular resistance is not related to the question.
that this type of aspiration pneumonia most commonly affects the right lower lung The right lower lung lobe does not have poorer venous drainage than the other lobes.
lobe?
A. The right main bronchus is narrower than the main bronchus. Gray's Anatomy Review. P 52
B. The right main bronchus is longer than the left main bronchus.
C. The right lower lung lobe has poorer venous drainage than the other lobes.
D. The right main bronchus is straighter than the left, main bronchus
12. A 3-year-old boy presents with pain in his groin that has been increasing in The deep inguinal ring lies in the transversalis fascia, just lateral to the inferior epigastric
nature over the past few weeks. Ho is found to have a degenerative vessels.
malformation of the transversalis fascia during development. Which of the The superficial inguinal ring is in the aponeurosis of the external oblique muscle. The inguinal
following structures on the anterior abdominal wall is LIKELY defective? ligament and the anterior wall of the inguinal canal are formed by the aponeurosis of the
external oblique muscle. The sac of a direct inguinal hernia is formed by the peritoneum.
A. Superficial inguinal ring
B. Inguinal ligament BRS Anatomy 8th Edition. P 151
C. Sac of a direct inguinal hernia
D. Deep inguinal ring

13. A neonatal baby was born with diabetes mellitus due to an inadequate Cells in the islets of Langerhans, an endocrine portion of the pancreas, are derived from the
production of insulin. Cells in the endocrine portion of the pancreas that endoderm of the caudal foregut (from the liver diverticulum). Proctodeum is an invagination
secrete insulin, glucagon, and somatostatin are derived from which of the of the ectoderm of the terminal part of the hindgut.
following?
A. Mesoderm BRS Anatomy 8th Edition. P 157
B. Proctoderm
C. Ectoderm
D. Endoderm
14. Observation of a histologic preparation of muscle reveals cross striations The histologic sample contains red fibers. The deductive process is based on the fact that the
and peripherally located nuclei. The use of histochemistry shows a strong sample must be skeletal or cardiac muscle due to the presence of cross-striations. The
staining reaction for succinic dehydrogenase. The same tissue prepared for presence of peripherally placed nuclei eliminates cardiac muscle as a possibility. Skeletal
electron microscopy shows many mitochondria in rows between myofibrils muscle may be subclassified into three muscle fiber types: red, white, and intermediate
and underneath the sarcolemma. Which one of the following is the best fibers. Red muscle fibers have a high content of cytochrome and myoglobin and, beneath the
description of this tissue? plasmalemma, contain many mitochondria required for the high metabolism of these cells.
Mitochondria are also found in a longitudinal array surrounding the myofibrils. The presence
A. White muscle fibers of numerous mitochondria provides a strong staining reaction with the use of cytochemical
B. Cardiac muscle stains such as that for succinic dehydrogenase.
C. Red muscle fibers
D. Smooth muscle Pretest Anatomy, Histology & Cell Biology 3rd edition P 223.
15. A 37-year-old man is suffering from carcinoma of the skin of the penis. The superficial inguinal nodes receive lymph from the penis, scrotum, buttocks, labium majus,
Cancer cells are likely to metastasize directly to which of the following lymph nodes? and the lower parts of the vagina and anal canal. These nodes have efferent vessels that drain
primarily into the external iliac and common iliac nodes and ultimately to the lumbar (aortic)
A. Aortic (lumbar) nodes nodes.
B. External iliac nodes
C. Internal iliac nodes BRS Anatomy 8th edition P. 205
D. Superficial inguinal nodes
 16. A 23-year-old woman visits her obstetrician for an annual checkup. During In addition to the uterine cervix, the uterus, uterine tubes, ovaries, and ureters can be
vaginal examination, which of the following structures may be palpated? palpated. The apex of the urinary bladder is the anterior end of the bladder; thus, it cannot be
A. Body of the clitoris palpated. The fundus of the uterus is the anterosuperior part of the uterus. The terminal part
B. Uterine cervix of the round ligament of the uterus emerges from the superficial inguinal ring and becomes
C. Fundus of the uterus lost in the subcutaneous tissue of the labium majus.
D. Apex of the urinary bladder
BRS Anatomy 8th edition P. 207
17. A 60-year old man was observed in the clinic. As he walked, the affected Circumduction or spastic gait which the leg is held stiffly and abducted with each step and
limb is moved forward by the abduction and circumduction. Which of the swung around to the ground in front, forming a semicircle
following BEST describes the gait in this patient?
Clinical application of neuromuscular techniques 2nd edition. P61-84
A. Parkinsonian
B. Spastic
C. Hemiplegic
D. Steppage
18. A type I diabetic pregnant 28-year-old is taking Humulin three times per Fibronectin is an adhesive glycoprotein that is important for cell attachment and adhesion. It
day. She complained of "floaters" and difficulty with nighttime driving. Dilated is important for modulation of cell migration in the adult and during development.
indirect ophthalmoscopy coupled with biomicroscopy and fundus photography
detect the presence of proliferative diabetic retinopathy with leaky retinal vessels Clinical vignettes for USMLE Step I P17
indicative of increased vascular permeability, growth of new, fragile vessels on the
retina and posterior surface of the vitreous, and macular edema. Overexpression of
fibronectin is a histological marker of diabetic microangiopathy. of the following is
the primary function of fibronectin in the basement membrane?

A. Binding to cadherins
B. Cell attachment and adhesion
C. Binding to actin filaments
D. Binding to selectins
19. A 6-year old boy presented for a routine physical examination. His right Clinical examination would show femoral pulses are usually impalpable or considerably
arm BP is 150/100 mmHg while his left 80/60 mmHg. A systolic murmur is weaker than the brachial pulse. Left brachial pulse may be weaker than the right if the origin
heard over the mid-upper back, his femoral pulses delayed as compared of the left subclavian artery is at the site of coarction. The apex beat may be displaced and
with the brachial. ECG showed left axis deviation. What is the most likely heaving because of the left ventricular hypertrophy.
diagnosis?
Pediatric Heart Disease: A Practical Guide. P 56.
A. Aortic stenosis
B. Mitral valve prolapse
C. Patent ductus arteriosus
D. Coarctation of tho aorta
20. A middle-aged coal minor injures his back after an accidental oxploaion. Denticulate Ligament is generally described as a specialization of the pia layer. It extends
His MRI scan reveals that his spinal cord has shifted to the right laterally from the spinal cord to attach to the dura mater within the spinal canal.
because the lateral extensions of the pia mater were torn. Function of
which of the following structure MOST likely impaired? Moore and Dalley, P 524-526

A. Coccygeal ligament
B. Tectorial membrane
C. Denticulate ligament
D. Choroid plexus
21. During a domestic dispute, a 17 y.o bow receives a deep stab wound around the superior (BRS Anatomy 8th Ed., pg. 48 #10)
angle of the scapula near the medial border, which injures both the dorsal scapular and The dorsal scapular nerve innervates the levator scapulae and rhomboid muscles, whereas the accessory
spinal accessory nerves. Such an injury could result in paralysis and weakness of which of nerve innervates the trapezius and sternocleidomastoid muscles. The serratus posterior superior is
the ff. muscles? innervated by ventral primary rami of the spinal nerves, whereas the splenius cervicis and erector spinae
A. Rhomboid minor and latissimus dorsi are innervated by dorsal primary rami of the spinal nerves.
B. Trapezius and serratus posterior superior
C. Rhomboid major and trapezius.
D. Splenius cevicis and sternocleidomastoid

22. A 39y.o small business manager sustained a gunshot wound in the pelvic cavity, resulting (BRS Anatomy 8th Ed., pg. 196, 211 #8)
in a lesion of the sacral splanchnic nerves. Which part of the ff. nerve fivers would The sacral splanchnic nerves consist primarily of preganglionic sympathetic neurons and also contain GVA
primarily be damaged? fibers. None of the other fibers listed are contained in these nerves.
A. Postganglionic sympathetic fibers
B. Preganglionic Parasympathetic fibers
C. Preganglionic sympathetic fibers
D. Postganglionic parasympathetic fibers

23. A 28 y.o patient comes in; he cannot flex the distal interphalangeal (DIP) joint of the index (BRS Anatomy 8th Ed., pg. 316)
finger. His physician determines that he has nerve damage from a supracondylar fracture. Injury to the median nerve may be caused by a supracondylar fracture of the humerus or a compression
Which of the ff. conditions is also a symptom of this nerve damage? in the carpal tunnel, resulting in loss of pronation, opposition, and abduction of the thumb, flexion of the
A. Atrophy of the hypothenar eminence lateral two interphalangeal joints, and impairment of the medial two interphalangeal joints. It also
B. Paralysis of all the thumb muscles produces the ape hand deformity (thenar eminence wasting and inability to abduct the thumb).
C. Inability to flex the DIP joint of the ring finger
D. Loss of sensation over the distal part of the second digit

24. A 17 y.o girl is admitted to the hospital with severe dyspnea. PE reveals that the patient is (Gray’s Anatomy Review 2nd Ed., pg. 73 #37)
suffering from an asthma attack, with associated bronchospasm. Which of the following The vagus nerve is the only nerve responsible for parasympathetic innervation of the lungs. The phrenic
nerves is responsible for the innervation of the bronchial smooth muscle cells? nerve and intercostal nerves are somatic nerves and are not involved in innervation of the heart or lungs.
A. Phrenic The greater thoracic splanchnic and lesser thoracic splanchnic nerves are responsible for carrying
B. Greater thoracic splanchnic preganglionic sympathetic fibers for the innervation of the abdomen. They also carry afferents for pain
C. Intercostal from the abdomen.
D. Vagus.

25. A 42-year-old female patient has been lying down on the hospital bed for more than 4 (Snell’s Clinical Anatomy by Regions, 9th Ed. p77)
months. Her normal, quiet expiration is achieved by contraction of which of the following “Quiet expiration is largely a passive phenomenon and is brought about by the elastic recoil of the lungs,
structures? the relaxation of the intercostal muscles and diaphragm, and an increase in tone of the muscles of the
anterior abdominal wall.”
A. Pectoralis minor muscle
B. Elastic tissue in the lungs and thoracic wall
C. Serratus posterior superior muscles
D. Serratus anterior muscles
26. A 53-year old man presented with symmetrical wasting of the intrinsic hand muscles, (Adams and Victor’s Principle of Neurology 10th Ed, p1111)
slowly progressing to more proximal muscles of the arms; diminished or absent tendon “The illness takes the form of a symmetrical (sometimes asymmetrical) wasting of intrinsic hand muscles,
reflexes. Given the signs and symptoms, which is the LIKELY disorder? slowly advancing to the more proximal parts of the arms; less often, the legs and thighs are the sites of the
initial atrophic weakness; or the proximal parts of the limbs are affected before the distal ones. Fascicular
A. Primary lateral sclerosis twitchings and cramping are variably present.
B. Progressive bulbar palsy Otherwise they differ from ALS only in that the tendon reflexes are diminished or absent, and signs of
C. Progressive spinal muscular atrophy corticospinal tract disease cannot be detected.”
D. Amyotrophic lateral sclerosis
(Bates’ Guide to Physical Examination and History Taking 11th Ed, p340)
27. A 26-year-old cardiac patient with an irregular heartbeat consulted a doctor. To listen to “Sounds and murmurs arising from the mitral valve are usually heard best at and around the cardiac apex.”
the sound of the mitral valve, the doctor should place the stethoscope

A. over the medial end of the second left intercostal space

B. in the left fifth intercostal space at the midclavicular
line
C. in the left fourth intercostal space at the midclavicular
D. over the medial end of the second right intercostal space
28. A pituitary adenoma is likely to result in which one of the following? (Robbins and Cotran Pathologic Basis of Disease 9th Ed, p1076)
See table 24-1
A. Diabetes insipidus
B. Deficiency in T3 and T4
C. Cushing syndrome
D. Stunted growth or dwarfism

45. A 33-year-old man with a perforated gastric ulcer complains of (Snell’s Clinical Anatomy by Regions, 9th Ed. p174)
excruciating pain in his stomach. It is observed that the pain comes “The sensation of pain in the stomach is caused by the stretching or spasmodic contraction of the smooth
from peritoneal irritation by gastric contents in the lesser sac. Which of the following nerves muscle in its walls and is referred to the epigastrium. It is believed that the pain transmitting fibers leave
contain sensory nerve fibers that convey this sharp, stabbing pain? the stomach in company with the sympathetic nerves. They pass through the celiac ganglia and reach the
spinal cord via the greater splanchnic nerves.”
A. White rami communicantes
B. Lower intercostal nerves
C. Greater splanchnic nerves
D. Gray rami communicantes
(Robbins and Cotran Pathologic Basis of Disease 9th E, p584)
46. Bong is a 6-year-old complaining of worsening pain in the right side of his groin for the “The nodes are swollen, gray-red, and engorged. Microscopically, there is prominence of large reactive
past week, Physical examination shows painful, swollen lymph nodes in the right inguinal germinal centers containing numerous mitotic figures. Macrophages often contain particulate debris
region. An inguinal lymph node biopsy is performed, and on microscopy the node has derived from dead bacteria or necrotic cells.
large, variably sized, germinal centers containing numerous mitotic figures. There are When pyogenic organisms are the cause, neutrophils are prominent and the centers of the follicles may
numerous parafollicular and sinusoidal neutrophils. What is the MOST likely cause of those undergo necrosis; sometimes the entire node is converted to a bag of pus. With
histologic changes? less severe reactions, scattered neutrophils infiltrate about the follicles and accumulate within the
lymphoid sinuses. The endothelial cells lining the sinuses undergo hyperplasia.”
A. Sarcoidosis
B. Follicular lymphoma
C. Acute lymphadenitis
D. Cat-scratch disease
47. A 10-year-old boy with atrial septal defect presents to a pediatrician. This congenital heart (Snell’s Clinical Anatomy by Regions, 9th Ed. p89)
defect shunts blood from the left atrium to the right atrium and causes hypertrophy of the “Most blood from the heart wall drains into the right atrium through the coronary sinus, which lies in the
right atrium, the right ventricle, and pulmonary trunk. Which of the posterior part of the atrioventricular groove and is a continuation of the great cardiac vein. It opens into
following veins opens into the hypertrophied atrium? the right atrium to the left of the inferior vena cava. The small and middle cardiac veins are tributaries of
the coronary sinus. The remainder of the blood is returned to the right atrium by the anterior cardiac vein
A. Small cardiac vein and by small veins that open directly into the heart chambers.”
B. Middle cardiac vein
C. Anterior cardiac vein
D. Oblique cardiac vein

48. A patient is rushed to the operating room for an emergent cholecystectomy because of (BRS Anatomy 7th Ed, p213)
cholecystitis. While locating landmarks before surgical resection of an infected gallbladder, the “Portal–Caval Anastomoses
surgeon recalls porta-caval anastomosis. Which of the following pairs of veins form a portal- 1. The left gastric vein and the esophageal vein of the azygos system.
caval anastomosis? 2. The superior rectal vein and the middle and inferior rectal veins.
3. The paraumbilical veins and radicles of the epigastric (superfi cial and inferior) veins.
A. Left and right gastric vein 4. The retroperitoneal veins draining the colon and twigs of the renal, suprarenal, and gonadal
B. Inferior and superficial epigastric veins veins.”
C. Superior and middle rectal vein
D. Suprarenal and renal veins
(Schwartz/s Principle of Surgery, 10th Ed., p1264)
49. A possible malignant mass from the liver of a neonate with cerebral palsy was resected. The “The round ligament is the remnant of the obliterated umbilical vein and enters the left liver hilum at the
pediatric surgeon divides the round ligament of the liver during surgery. A fibrous remnant of front edge of the falciform ligament.”
which of the following fetal vessels is severed?

A. Ductus arteriosus
B. Ductus vanosus
C. Left umbilical vein
D. Right umbilical vein
50. A 42-year-old woman visits the outpatient clinic due to painful urination. A dipstíck test (Gray’s Anatomy Review, p117,127)
reveals leukocytosis, which confirms the diagnosis of urinary tract infection. Which of the See Pelvis and Perineum, question 45
following is the BEST anatomic explanation for the fact that women are more susceptible to
urinary tract infections then men?

A. The urethra is located within the vagina.

B. The seminal vesicles produce fluids resistant to bacteria.
C. The prostate gland produces antibacterial prostatic fluids.
D. The urethra is much shorter in females
51. A 64-year-old man presents with back pain, weakness, and shortness of breath. On (Snell’s Clinical Anatomy by Regions, 9th Ed. p46)
examination, he has an aneurysm of the abdominal aorta at the aortic hiatus of the diaphragm. “The aortic opening transmits the aorta, the thoracic duct, and the azygos vein.”
Which of the following pairs of structures would MOST likely be compressed?

A. Esophagus and vagus nerve

B. Thoracic duct and vagus nerve
C. Azygos vein and thoracic duct
D. Vagus nerve and azygos vein
52. A 25-year-old man undergoing chemotherapy for acute lymphoblastic leukemia developed (Robbins Review of Pathology, p141,150)
fever and abdominal pain within the past week. He now has a severe cough. Temperature is See Diseases of Organ Systems: White Cells, Lymph nodes, Spleen and Thymus, question 37
38.4° C. Crackles are heard over all lung fields. Lab studies show hemoglobin, 12.8g/dl; The eosinophilia suggests parasitic infection.
hematocrit, 39%; MCV, 90 um3; platelet count, 221,000/mm3; and WBC count, 16,475/mm3
with 51% segmented neutrophils, 5% bands, 18% lymphocytes, 8% monocytes, and 18%
eosinophils. Infection with which of the following organisms is MOST likely to be complicating
the course of this patient's disease?

A. Toxoplasma gondii
B. Strongyloides stercoralis
C. Cryptococcus neoformans
D. Pseudomonas aeruginosa
53. A 32-year-ald woman has hoarseness in her voice, and her uvula is deviated to the left on (BRS Anatomy 7th Ed, p392)
phonation. Which of the following nerves is damaged? “A lesion of the vagus nerve deviates the uvula to the opposite side.”

A. Left trigeminal nerve

B. Right trigeminal serve
C. Left vagus nerve
D. Right vagus nerve
54. Measuring T3 levels does not necessarily accurately depict the thyroid's ability to secrete T3 (Robbins and Cotran Pathologic Basis of Disease 9th E, p1083)
for which one of the following reasons? “In the periphery, the majority of free T4 is deiodinated to T3.”

A. T3 and T4 are regulated by two different anterior pituitary

B. T4 and T3 immunoassays crass-react in immunoassays.
C. T3 is bound to thyroid-hormone binding proteins.
D. The liver and kidney convert T4 to T3 peripherally
55. A 47-year-old man cannot move his eye laterally. Which of the following conditions would (Adam and Victor’s Principle of neurology 10th ed, p271)
cause this type of inability to move the eye? “Lesions of the sixth nerve result in a paralysis of the abducens muscle and a resultant weakness of lateral
or outward movement leading to a crossing of the visual axes.”
A. Tumor of the pituitary gland
B. Infection in the cavernous sinus
C. Occlusion of the posterior cerebral artery
D. Infection in the maxillary sinus
56. A 50-year-old heavy smoker has an advanced lung cancer that spread into her right third (BRS Anatomy 7th Ed, p164)
intercostal space posterior to the midaxillary line. If cancer cells are carried in the venous ‘The second, third, and often the fourth intercostal veins join to form the superior intercostal vein.”
drainage, they would trave1 first to which of the following veins?

A. Hemiazygos vein
B. Right superior intercostal vein
C. Azygos vein
D. Right brachiocephalic vein

57. A 37-year-old patient has an infectious inflammation of the dural venous sinus closest to (Snell’s Clinical Anatomy by Regions, 9th Ed. p544)
the pituitary gland and a secondary thrombus formation. Which of the following is the MOST “Important structure/s associated with cavernous sinuses: one is the pituitary gland, which lies medially in
likely site of infection? the sella turcica.”

A. Straight sinus
B. Sigmoid sinus
C. Superior petrosal sinus
D. Cavernous sinus
58. A 28-year old man presents to the ER after a high-speed motor vehicle accident. Neurologic (Snell’s Clinical Anatomy by Regions, 9th Ed. p703)
exam showed the lowest functioning neurologic level is C5. Which is the LIKELY finding in this See Table 12.1
patient given the neurologic assessment level?

A. Flexion of the distal interphalangeal joints is intact; finger adduction and abduction is not
functional
B. Sensation is intact over and just inferior to the clavicle;
sensation is not intact over the lateral aspect of the
shoulder and deltoid region
C. Deltoid and biceps motor function is intact; extensor carpi
radialis longus and brevis muscles are not functional
D. The anal sphincter is flaccid when the glans penis is squeezed

59. A 35-year-old woman is admitted to the ER with severe left abdominal and back pain. (Snell’s Clinical Anatomy by Regions, 9th Ed. p209)
Radiographic evaluation reveals that the left ureter is blocked with a kidney stone. Because the “Posterior relation to the left ureter: bifurcation of the left common iliac artery.”
ureter is completely obstructed, an emergency surgical procedure must be performed. The
MOST reliable landmark for the identification of the ureter is that the left ureter is anterior to
the left

A. renal vein.
B. common iliac artery.
C. gonadal artery.
D. inferior epigastric artery.
60. A 56-year old woman was diagnosed with bitemporal hemianopia. Where is the lesion of (Gray’s Clinical Neuroanatomy- The Anatomic Basis for Clinical Neuroscience, p219)
this visual field defect? See fig.12-11

A. Lesion of the calcarine cortex

B. Lesion of the tip of the occipital lobe
C. Lesion of the optic chiasm
D. Lesion behind the optic chiasm

61. Sympathectomy may occasionally relieve intractable pain of visceral origin, since visceral [Clinical Anatomy by Regions 9th Ed, page 184]
afferent pain fibers run along the sympathetic pathways in the abdomen. The autonomic
control of peristalsis in the descending colon should not be affected by bilateral lumbar
sympathectomy for which one of the following reasons?
A. The descending colon receives its sympathetic innervation from thoracic splanchnic nerves
B. The descending colon receives its parasympathetic innervation from the vagus nerve
C. The descending colon is controlled chiefly by parasympathetic innervation from the pelvic
splanchnic nerves.
D. Lumbar splanchnics from L1, L2, and L3 only innervate the pelvic viscera via the hypogastric
nerve
62. A 28-year old man has fever with chills and rigors for the past two weeks. Temperature is Chronic infections and ongoing inflammatory conditions such as lung abscesses, can lead to an expansion
39.2° C. CBC shows haemoglobin 13.9 g/dL; haematocrit 40.5%; MCV 93 µm3; platelet count of the myeloid precursor pool in the bone marrow with myeloid hyperplasia. [Robbins and Cotran Review
210,000/mm3; and WBC count 13,750/mm3. A bone marrow biopsy specimen shows of Pathology 4th Ed, page 183 and 195]
hypercellularity. Which of the following is the MOST likely to cause this findings?
A. Splenomegaly
B. Glucocorticoid therapy
C. Acute viral hepatitis
D. Lung Abscess.
63. An 18-year-old girl is thrust into the stearing wheel while driving and experiences difficulty The abdominal muscles are the major muscles of expiration, whereas the other distractors are muscles of
in expiration. Which of the following muscles is MOST likely damaged? inspiration. [Board Review Series: Gross Anatomy 7th Ed, page 174 and 180]
A. External intercostal muscle
B. Muscles of the abdominal wall.
C. Levator costarum
D. Innermost intercostal muscle
64. A 38-year-old man infected with HIV for the past 10 years is admitted to the hospital with This HIV positive patient has an extranodal infiltrative mass, composed of B cells (CD19+), in the ileum. This
abdominal pain of 3 days’ duration. PE shows abdominal distention and absent bowel sounds. An is a diffuse large-cell lymphoma of B cells. These tumors contain the Epstein - Barr virus genome, and is
abdominal CT scan shows a mass lesion involving the ileum. He undergoes surgery to remove an thought that immunosuppression allows unregulated proliferation and neoplastic transformation of EBV-
area of bowel obstruction in the ileum. Gross examination of the specimen shows a firm, white infected B cells. [Robbins and Cotran Review of Pathology 4th Ed, page 186 and 198]
mass, 10 cm long and 3 cm at its greatest depth. The mass has infiltrated through the wall of the
ileum. Histologic studies show a mitotically active population of CD19+ lymphoid cells with
prominent nuclei and nucleoli. Molecular analysis is MOST likely to show which of the following
viral genomes in the lymphoid cells?
A. Cytomegalovirus
B. Human T-cell lymphotropic virus type I
C. Human herpesvirus B
D. Epstein-Barr Virus.
65. A 58-year old man is admitted due to left flank pain. Blood exam indicates hematuria and Inferior Vena Cava receives the right and left renal veins. The left renal vein runs posterior to the superior
anemia. MRI reveals that blood flow in the left renal vein is being occluded by an arterial mesenteric artery anterior to the abdominal aorta. [Board Review Series: Gross Anatomy 6th Ed, page 216]
aneurysm where the vein crosses the aorta. The aneurysm is MOST likely located in which artery?
A. Left colic
B. Superior Mesenteric
C. Inferior mesenteric
D. Celiac
66. A 60-year-old man is diagnosed with prostate cancer following a digital rectal examination. Ducts from the prostate gland open into the prostatic sinus, which is a groove on either side of the urethral
For the resection of prostate cancer, it is important to know that the prostatic ducts open into or crest. [Board Review Series: Gross Anatomy 7th Ed, page 284 and 291]
on which of the following structures?
A. Prostatic utricle
B. Prostatic Sinus
C. Seminal colliculus
D. Spongy urethra
67. A patient bleeding from the shoulder secondary to a knife wound is in fair condition because The dorsal scapular artery arises directly from the third part of the subclavian artery and replaces the deep
there is vascular anastomosis around the shoulder. Which of the following arteries is MOST likely (descending) branch of the transverse cervical artery. The suprascapular and transverse cervical arteries
a direct branch of the subclavian artery that is involved in the anastomosis? are branches of the thyrocervical trunk of the subclavian artery. The thoracoacromial artery is a short trunk
A. Circumflex Scapular Artery from the first or second part of the axillary artery and has pectoral, clavicular, acromial, and deltoid
B. Dorsal Scapular Artery. branches. [Board Review Series: Gross Anatomy 7th Ed, page 66 and 76]
C. Suprascapular Artery
D. Thoracoacromial Artery
68. A 22-year old man has a gonorrheal infection that has infiltrated the space between the The bulb of the penis is located in the superfi cial perineal space between the
inferior fascia of the urogenital diaphragm and the superficial perineal fascia. Which of the inferior fascia of the urogenital diaphragm and the membranous layer of the superfi cial perineal fascia
following structures might be inflamed? (Colles’s fascia). All of the other structures are found in the deep perineal pouch. [Board Review Series:
A. Membranous part of the male urethra Gross Anatomy 7th Ed, page 285 and 291]
B. Bulbourethral gland
C. Bulb of the Penis
D. Deep transverse perineal muscle
69. A 63-year old man presents with splenomegaly, lymphadenopathy, persistent fever, night The sternum is a common site for bone marrow biopsy because it possesses hematopoietic marrow
sweats, and weight loss. Bone marrow aspiration and biopsy are scheduled. The BEST place to throughout life and because of its breadth and subcutaneous position. [Board Review Series: Gross
take sample bone marrow is in the ______. Anatomy 7th Ed, page 133]
A. Sternum
B. Scapula
C. Iliac crest
D. Humerus
70. A 47-year old woman is admitted due to sharp and constant abdominal pain, beginning in the Cystic Duct obstruction, usually by gallstones, results in acute inflammation of the gallbladder (cholecystitis)
epigastric region and radiated bilaterally around the chest to just below the scapulae. The pain that initially presents as epigastric pain, but pain may be referred to T5-T9 dermatomes of the back below
later became localized in the right hypochondrium. Similar but milder attacks were noted after the right scapula. Pain is referred to these dermatomes because visceral afferent fibers from foregut
hearty meals, is moderately overweight. PE showed marked tenderness in the right derivatives accompany sympathetic fibers of the greatr splanchnic nerve. [Rapid Review: Gross and
hypochondriac region and some rigidity of the abdominal musculature. An x-ray without contrast Developmental Anatomy 3rd Ed, page 83]
medium shows numerous calcified stones in the region of the gallbladder. There was no sign of
jaundice. Diffuse pain referred to the epigastric region and radiating circumferentially around the
chest is the result of afferent fibers that travel via which of the following nerves?
A. Intercostal
B. Vagus
C. Phrenic
D. Greater Splanchnic Nerve.
71. During a snowstorm, a 53-year old man sustained multiple car accident. Which of the Whiplash injury of the neck is produced by a force that drives the trunk forward while the head lags behind.
following conditions is produced by a force that drives the trunk forward while the head lags Scoliosis is a lateral deviation resulting from unequal growth of the spinal column. Hangman’s fracture is a
behind in a rear-end automobile collision? fracture of the neural arch through the pedicle of the axis that may occur as a result of hanging or motor
A. Herniated disk vehicle accidents. Meningomyelocele is a protrusion of the spinal cord and its meninges. A herniated disk
B. Hangman fracture compresses the spinal nerve roots when the nucleus pulposus is protruded through the annulus fibrosus.
C. Meningomyelocele [Board Review Series: Gross Anatomy 7th Ed, page 319 and 323]
D. Whiplash Injury.

72. A 43- year old man has a new onset of difficulty with speaking. Examination by the ENT The digastric posterior belly is innervated by the facial nerve, whereas the digastric anterior belly is
resident reveals problem in elevating the hyoid bone and floor of the mouth, secondary to innervated by the trigeminal nerve. The accessory nerve supplies the sternocleidomastoid and trapezius
paralysis of the posterior belly of the digastric muscle. Which of the following nerves is most likely muscles. The ansa cervicalis innervates the infrahyoid (or strap) muscles. The glossopharyngeal nerve
involved? supplies the stylopharyngeus muscle. [Board Review Series: Gross Anatomy 7th Ed, page 430 and 441]
A. Ansa cervicalis
B. Accessory nerve
C. Facial nerve
D. Trigeminal nerve
73. A 54-year-old man is admitted to the hospital due to severe headaches. A CT examination [Gray’s Anatomy Review, page 217 and 246]
reveals an internal carotid artery aneurysm inside the cavernous sinus. Which of the following
nerves would be typically affected first?
A. Oculomotor nerves
B. Ophthalmic nerve
C. Abducens nerve
D. Maxillary nerve
74. A 5-year-old boy with breathing difficulty, chest pain, and cough was admitted to a local Cystic fibrosis affects the respiratory system by causing an excess production of viscous mucus by the
hospital. The paediatrician who examined the boy, along with laboratory results, diagnosed the bronchial glands, followed by mucous plugging and obstruction of the respiratory airway. The other
child as having cystic fibrosis. Which of the following structures is MOST likely blocked? structures are not affected because they are large airways. [BRS: Gross Anatomy 6th Ed, page 172 and 178]
A. Alveolar duct
B. Terminal Bronchioles
C. Secondary or Lobar Bronchi
D. Primary bronchus
75. A 46-year old woman presented with the drop foot with the affected limb lifted higher thatn The patient with a steppage gait has weak or paralyzed dorsiflex muscles, rsulting in a drop foot.
normal. Which of the following is the LIKELY gait in this patient? [Orthopedic Physical Assessment 5th Ed, page 969]
A. Spastic
B. Parkinsonian
C. Ataxic
D. Steppage Gait.
76. During the physical examination of a newborn child, it is observed that the genitalia are Congenital adrenal hyperplasia stems from several autosomal-recessive, inherited metabolic errors, each
female but masculinized. The genotype is determined to be 46,XX. Which one of the following is characterized by a deficiency or total lack of a particular enzyme involved in the biosynthesis of cortical
the MOST likely cause of this condition? steroids, particularly cortisol. 21-hydroxylase deficiency (caused by mutations of CYP21A2) is by far the most
A. Androgen insensitivity common, accounting for over 90% of cases. Simple virilizing adrenogenital syndrome without salt wasting
B. Defect in Cortisol Pathway (presenting as genital ambiguity) occurs in approximately a third of patients with 21-hydroxylase deficiency.
C. Atrophy in the zona reticularis
D. Decreased blood ACTH levels
77. A 16-year old boy suffers a traumatic groin injury during a soccer match. The urologist notices A tender swollen left testis may be produced by thrombosis in the left renal vein because the left testicular
tenderness and swelling of the boy’s left testicle that may be produced by thrombosis in which vein drains into the left renal vein. The right testicular vein drains into the inferior vena cava. The left
of the following veins? internal pudendal vein empties into the left internal iliac vein. The left inferior epigastric vein drains into
A. Left internal pudendal vein the left external iliac vein, and the left external pudendal vein empties into the femoral vein. [Board Review
B. Inferior vena cava Series: Gross Anatomy 7th Ed, page 283 and 290]
C. Left renal vein
D. Left inferior epigastric vein
78. A 25-year old man falls from his motorcycle and lands in a creek. Death may result from Bilateral severance of the vagus nerve (CN X) causes a loss of refl ex control of circulation because of an
bilateral severance of which of the following nerves? increase in heart rate and blood pressure; poor digestion results because of decreased gastrointestinal
A. Facial Nerve motility and secretion; and diffi culty in swallowing, speaking, and breathing occurs because of paralysis of
B. Trigeminal Nerve laryngeal and pharyngeal muscles. All of these effects may result in death. Bilateral severance of other
C. Vagus Nerve nerves does not cause death. [Board Review Series: Gross Anatomy 7th Ed, page 428]
D. Spinal Accessory Nerve

79. A 45-year old woman presented with symmetrical weakness and atrophy of the pelvic girdle This rare disorder arises sporadically in adults in mid to late life. Clinically, PLS is characterized by
and proximal leg muscles; later involvement of the shoulder girdle and upper arm muscles; progressive spastic weakness of the limbs, preceded or followed by spastic dysarthria and dysphagia,
finally, involvement of the distal limbs and absence of tendon reflexes. Given the signs and indicating combined involvement of the corticospinal and corticobulbar tracts. [Harrison’s Principles of
symptoms, which is the LIKELY disorder? Internal Medicine 20th Ed, page 3147]
A. Amyotrophic lateral sclerosis
B. Progressive spinal muscular atrophy
C. Chronic proximal progressive spinal muscular atrophy
D. Primary lateral sclerosis
80. A 58-year old female employee of a housecleaning business visits the outpatient clinic with a Prepatellar bursitis (housemaid’s knee) is infl ammation and swelling of the prepatellar bursa. [Board
complaint of constant, burning pain in her knees. Clinical examination reveal a “housemaid’s Review Series: Gross Anatomy 7th Ed, page 91]
knee” condition. Which of the following structures is MOST likely affected?
A. Patellar retinacula
B. Infrapatellar bursa
C. Lateral meniscus
D. Prepatellar bursa.
81. Coronary angiographs of a 43-year-old male patient reveal an occlusion of the circumflex https://en.wikipedia.org/wiki/Circumflex_branch_of_left_coronary_artery#Structures_supplied
branch of the left coronary artery. This patient has been suffering from myocardial infarction in
which of the following areas?
a. Right and left ventricles
b. Right and left atria
c. Interventricular septum
d. Left atrium and ventricle

82. A 16-year-old female was admitted with bilateral inguinal masses. She had not begun to Gray's Anatomy Review p69
menstruate but showed normal breast development for her age. Her external genitalia were
feminine, the vagina was shallow, but no uterus could be palpated. Laboratory examination
revealed that her sex chromatin pattern was negative. Which of the following is the MOST likely
diagnosis?
a. Male pseudohermaphroditism
b. Turner syndrome
c. Female pseudohermaphroditism
d. Androgen insensitivity syndrome

83. A 16-year old presented with BP 140/55 mmHG at rest. A large, healed scar is noted on the https://pubmed.ncbi.nlm.nih.gov/24472357/
medial aspect of the left thigh which he acquired when he hit a large nail during a fall. Bruit and
a palpable thrill were noted on the scar. What is the patient LIKELY to have?
a. Compression of the femoral artery
b. Congenital duplication of the femoral artery
c. An arteriovenous fistula
d. Premature atherosclerosis

84. A 6-year-old boy is admitted to the hospital with high fever and pain over the parotid gland. https://teachmeanatomy.info/head/organs/salivary-glands/parotid/
A diagnosis of parotiditis (mumps) is established, and the boy is sent back home. Which of the
following nerves is responsible for painful sensations from the region of the parotid gland.
a. Lingual
b. Auriculotemporal
c. Chorda tympani
d. Lesser petrosal

85. A 38-year-old woman with a long history of shoulder pain is admitted to a hospital for https://en.wikipedia.org/wiki/Transverse_cervical_artery#Superficial_branch
surgery. Which of the following muscles becomes ischemic soon after ligation of the superficial
or ascending branch of the transverse cervical artery?
a. Rhomboid major
b. Latissimus dorsi
c. Multifi dus
d. Trapezius

86. A 56-year-old man, 41-pack year smoked had a "typical smoker's cough" for years which had https://en.wikipedia.org/wiki/Endostatin
turned into a chronic productive cough with hemoptysis. He has dyspnea, chest pain, cachexia,
and increasing dysphonia. He has been treated for 4 respiratory infections in the past 18
months. Imaging reveals a tumor that is 3 cm in greatest dimension, surrounded by lung
parenchyma. Bronchoscopic evaluation reveals a cavitary lesion of a proximal bronchus. The
tumor was classified as T1, N2, M0 squamous cell carcinoma. Immunocytochemistry indicates a
highly vascular tumor with many microvessels. Vascularity of the tumor is inhibited by up-
regulation of which of the following?
a. Vascular endothelial growth factor (VEGF)
b. Platelet-derived growth factor (PDGF)
c. Endostatin
d. Extracellular matrix synthesis

87. A pediatric surgeon has resected a structure that is a fibrous remnant of an embryonic or https://www.med.umich.edu/lrc/coursepages/m1/embryology/embryo/18changesatbirth.htm
fetal artery in a 5-yearold child. Which of the following structures is MOST likely to be divided? https://en.wikipedia.org/wiki/Lateral_umbilical_fold
a. Ligamentum teres hepatis
b. Lateral umbilical fold
c. Medial umbilical fold
d. Ligamentum venosum

88. A 20-year-old woman complains of numbness of the nasopharynx after surgical removal of BRS Gross Anatomy 8th Edition p435
the adenoid. A lesion of which of the following nerves would be expected?
a. Superior cervical ganglion
b. External laryngeal nerve
c. Glossopharyngeal nerve
d. Maxillary nerve

89. A 37-year-old man receives a direct blow to his head and is brought to an emergency BRS Gross Anatomy 8th Edition p440
department. His radiograph shows a fracture of the floor of the middle cranial cavity, causing
severance of of the greater petrosal nerve. Which of the following conditions could be produced
by this injury?
a. Decreased parotid gland secretion
b. Loss of taste sensation in the epiglottis
c. Dryness in the nose and palate
d. Increased lacrimal gland secretion

90. A 20-yearold marine biologist asks about her first bimanual examination, and it is explained https://www.ncbi.nlm.nih.gov/books/NBK470297/
to her that the normal position of the uterus is _____.
a. anteflexed and retroverted
b. retroflexed and anteverted
c. anteflexed and anteverted
d. retroverted and retroflexed

91. A 42-year old man presented with stiffness of the fingers associated with weakness of the Macnab's Backache 4th edition
hand, followed by atrophic weakness of the hands and forearms, slight spasticity of the legs, ALS New Research by Christine Murray
and generalized hyperreflexia. Given the signs and symptoms, which is the LIKELY disorder?
a. Primary lateral sclerosis
b. Progressive spinal muscular atrophy
c. Progressive bulbar palsy
d. Amyotrophic lateral sclerosis

92. A 16-year-old female was admitted with bilateral inguinal masses. She had not begun to Gray's Anatomy Review p69
menstruate but showed normal breast development for her age. Her external genitalia were
feminine, the vagina was shallow, but no uterus could be palpated. Laboratory examination
revealed that her sex chromatin pattern was negative. Which of the following is the MOST likely
diagnosis?
a. Turner syndrome
b. Androgen insensitivity syndrome
c. Inguinal hernias
c. Male pseudohermaphroditism
93. A woman is delivering a breech baby. The obstetrician decides that it is best to perform a https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841321/
mediolateral episiotomy. Which of the following structures should the obstetrician avoid
incising?
a. Bulbospongiosus
b. Perineal membrane
c. Vaginal wall
d. Levator ani

94. A 73-year-old man comes to his physician for an annual checkup. Which of the following https://pubmed.ncbi.nlm.nih.gov/27535076/
structures is most readily palpated during rectal examination?
a. Ejaculatory duct
b. Prostate gland
c. Epididymis
d. Ureter

95. A 68-year-old male is admitted to the hospital with painful urination and nocturia. MRI Gray's Anatomy Review p114
examination reveals enlargement and irregularity of the uvula of the urethra. This enlargement
resulted in difficulty with urinary voiding and inadequate emptying of the bladder. Which of the
following lobes of the prostate gland will most likely be hypertrophied?
a. Anterior
b. Lateral
c. Median
d. Posterior

96. A 28-year-old woman with a goiter is scheduled for surgical treatment. The surgeon must https://en.wikipedia.org/wiki/Superior_laryngeal_nerve see external laryngeal nerve
ligate the superior laryngeal artery before surgically resecting the goiter, so care must be taken
to avoid injury to which of the following nerves?
a. Superior laryngeal nerve
b. Internal laryngeal nerve
c. External laryngeal nerve
d. Hypoglossal nerve

97. A 22-year-old woman receives a deep cut in the inguinal canal 1 in. lateral to the pubic https://en.wikipedia.org/wiki/Inguinal_canal
tubercle. Which of the following ligaments is lacerated within the inguinal canal
a. Rectouterine ligament
b. Ovarian ligament
c. Suspensory ligament of the ovary
d. Round ligament of the uterus

98. A 54-year-old female is admitted to the hospital with a stab wound of the thoracic wall in http://web.as.uky.edu/Biology/faculty/cooper/KMA/lungs%20pdf.pdf
the area of the right fourth costal cartilage. Which of the following pulmonary structures is
present at this site?
a. The apex of the right lung
b. The root of the left lung
c. The horizontal fissure of the left lung
d. The horizontal fissure of the right lung

99. A 34-year-old man in a bar fight suffers a knife wound that severs the abducens nerve BRS Gross Anatomy 8th Edition p471
proximal to its entrance into the orbit. Which of the following conditions results from this
injury?
a. Ptosis of the upper eyelid
b. Internal strabismus (medial deviation)
c. Loss of the ability to dilate the pupil
d. External strabismus (lateral deviation)

100. A known diabetic mother gives birth to a baby who is diagnosed as having dextroposition BRS Gross Anatomy 8th Edition p97
of the aorta and the pulmonary trunk with cyanosis and shortness of breath. Which of the
following structures is required to remain patent until surgical correction of the deformity?
a. Umbilical arteries
b. Ductus venosus
c. Umbilical vein
d. Ductus arteriosus